Finding 382751 (2023-002)

Material Weakness
Requirement
E
Questioned Costs
$1
Year
2023
Accepted
2024-03-21
Audit: 296356
Organization: Phoenix Houses of Texas, Inc. (TX)

AI Summary

  • Core Issue: Ineligible clients received services and were billed to the grant due to inadequate documentation and internal control failures.
  • Impacted Requirements: Texas Administrative Code mandates proper eligibility checks, including financial verification and documentation before billing for Substance Use Disorder treatment services.
  • Recommended Follow-Up: Implement additional staff training to reinforce adherence to internal control procedures for client eligibility and documentation requirements.

Finding Text

Finding #2023-002 – Material Weakness and Other Noncompliance. Applicable federal program: U. S. Department of Health and Human Services, Assistance Listing #93.959, Passed through Texas Department of Health and Human Services, Contract #’s: HHS000663700277 and HHS000663700278, Contract years: 09/21 – 08/22; 09/22 – 08/23. Applicable state program: Texas Department of Health and Human Services, Contract #’s: HHS000663700277 and HHS000663700278, Contract year: 09/21 – 08/22. Criteria: Eligibility – Texas Administrative Code (TAC) requirements, as referenced in the Substance Use Disorder (SUD) Utilization Management (UM) Guidelines requires that Federal Block Grant-funded SUD treatment services will be provided to all eligible Texas residents. Client eligibility for Texas residency, financial eligibility, and clinical eligibility must be performed prior to billing HHSC for SUD treatment services. Further, providers are to conduct and document in CMBHS the financial eligibility determination. If the client is unable to provide proof of financial status, the individual can attest by signing an attestation statement. Condition and context: During our testing of 40 clients for proper eligibility, three clients had documented income verification that did not meet the income guidelines specified under the grant. Despite this, services were provided to these clients, and the costs were billed to the grant. Furthermore, one client out of the 40 tested did not have proper documentation to support the financial eligibility determination, and there was no attestation statement from the client explaining the inability to provide the necessary information. Cause: The finding occurred as a result of Phoenix House not following its internal control procedures requiring review of documentation to ensure the client files are complete with eligibility documentation and that only eligible clients are being billed to the grant. Effect: Failure to follow internal control procedures resulted in incomplete client files and ineligible persons served. Questioned costs: The grant was billed $282.54 for the four clients in the billing months selected in our testing. Recommendation: Provide additional staff training to ensure internal control procedures over client eligibility and required documentation are followed. Views of responsible officials and planned corrective action: Management agrees with the finding. See Corrective Action Plan.

Corrective Action Plan

Finding #2023-002 – Material Weakness and Other Noncompliance. Recommendation: Provide additional staff training to ensure internal control procedures over client eligibility and required documentation are followed. Planned corrective action: Client eligibility and documentation requirements do not pertain to cost reimbursement grants; these regulations exclusively apply to fee-for-service grants. The fee-for-service grant programs concluded on September 30, 2023. Consequently, starting from October 1, 2023, the business model shifted to cost reimbursement only. As a result, no corrective actions are needed for fee-for-service grants. Responsible officer: Drew Dutton, President and CEO. Estimated completion date: Completed October 1, 2023

Categories

Questioned Costs Eligibility Material Weakness

Other Findings in this Audit

  • 382749 2023-001
    Significant Deficiency
  • 382750 2023-001
    Significant Deficiency
  • 382752 2023-001
    Significant Deficiency
  • 382753 2023-001
    Significant Deficiency
  • 382754 2023-002
    Material Weakness
  • 382755 2023-001
    Significant Deficiency
  • 382756 2023-001
    Significant Deficiency
  • 959191 2023-001
    Significant Deficiency
  • 959192 2023-001
    Significant Deficiency
  • 959193 2023-002
    Material Weakness
  • 959194 2023-001
    Significant Deficiency
  • 959195 2023-001
    Significant Deficiency
  • 959196 2023-002
    Material Weakness
  • 959197 2023-001
    Significant Deficiency
  • 959198 2023-001
    Significant Deficiency

Programs in Audit

ALN Program Name Expenditures
93.498 Provider Relief Fund $421,266
10.555 National School Lunch Program $63,143
10.553 School Breakfast Program $32,336
93.959 Block Grants for Prevention and Treatment of Substance Abuse $603